2023 Volume 32 Issue 4 Pages 333-338
Objective: To evaluate the early clinical outcomes of endovascular aneurysm repair (EVAR) with physician-modified branched endoprosthesis for iliac artery aneurysms unsuitable for manufactured iliac branch endoprosthesis (W. L. Gore & Associates Incorporated, Flagstaff, AZ, USA). Methods: A total of 8 cases of iliac artery aneurysms between October 2019 and April 2023, underwent EVAR with physician-modified branched endoprosthesis. The endoprosthesis was made of AFX leg extension (Endologix Incorporated, Irvine, CA, USA) with hydrogel-reinforced fenestration to provide a secure connection with the branching graft. Their early clinical outcomes and computed tomography (CT) data were retrospectively analyzed. Results: Viabahn (W. L. Gore & Associates Incorporated, Flagstaff, AZ, USA) were used as branching grafts for the reconstruction of internal iliac artery or superior gluteal artery in 7 cases. Moreover, coil embolism of inferior gluteal artery was performed in 3 cases. Although 1 case had a type 2 endoleak from the iliolumbar artery, a reduction of aneurysmal diameter was observed in all of the cases. Furthermore, no complications such as buttock claudication were observed in patients. Conclusion: EVAR with physician-modified branched endoprosthesis for the iliac artery aneurysm was less costly, performed within a reasonable time, and demonstrated favorable early outcomes with respect to preventing buttock claudication and the reduction of the aneurysmal diameter.
